Adoption Application

Our goal is to create a community where healthy animals are not killed in the shelter, and animals are kept safe, healthy and loved in their homes! Thank you for your interest in adopting a rescued dog! Once your adoption application is received, we will send you confirmation that it is being reviewed. PLEASE fill out all information in order for us to help you efficiently. One of our dedicated volunteers will be in touch regarding any questions you may have. Please allow at least a week for processing.

Prior to adoption, all dogs receive the following: parvo/distemper vaccination, rabies vaccination, heartworm test and treatment (if needed), spay/neuter, and microchip.
Adopters must be at least 21 years old.
Dogs must go to indoor ONLY homes! Dogs must be walked on a leash AT ALL TIMES or in a secure fenced in yard!
A completed application and physical home visit are required prior to adoption! We do a trial adoptions ( at least 14 days)

Please view our complete adoption policies here.

If you prefer to complete this on paper and scan/email it to us, please download the form here.

Submission Date:

MonthDayYear

How did you hear about us?*

In which dog(s) are you interested?*

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail:

Primary Phone (only numbers allowed):*

Alternate Phone:

Please describe in detail the perfect pet for you, including age, size, sex, breed and temperament. If the pet you are interested in is not available, we will be happy to help find the perfect-fit rescue dog for your household:

Family Information

Please list how many adults / children are in your household with ages *

Home Information

Do you own or rent?*

OwnRent

If you rent, please provide the name and phone number of your landlord. We will want to confirm with your landlord that you will be permitted to have a pet in your home.

How long have you lived at your current address? *

Please describe your neighborhood:*

Does your home have a yard?*

YesNo

Does fencing completely enclose the yard?

YesNo

If not, explain how and where you will allow a dog to exercise and relieve itself?

If your yard is fenced, please describe what kind (type and height):

Some insurance companies may cancel your homeowner’s insurance if there is a pet on the premises. It is your responsibility to check with your agent to ensure that adopting a pet will not adversely affect your policy. For breeds which may be “blacklisted” with insurers (for example pit bull-type dogs, German shepherds, Rottweilers, chows) we may require your permission to check your insurance company general policies for breed restrictions.

Other Pet Information

Have you adopted or fostered a pet before?*

YesNo

If yes, which group or shelter

Do you have others pets at this time?*

YesNo

If you have other pets, please list all current animals in your household. Please include any foster pets and add which rescue/organization is responsible for your foster pet

	Breed	Age	Sex	Spayed/Neutered	Name/Other Information/Foster info
Pet #1
Pet #2
Pet #3
Pet #4
Pet #5
Pet #6
Pet #7
Pet #8

If you currently own other pets:

Are your pets up to date on vaccinations?

YesNo

If no, why not?

Are they currently on heartworm/flea and tick preventative?

YesNo

Are they indoors or outdoors?

IndoorsOutdoors

Do your pets get along with (tolerate) other animals?

YesNo

If no, please explain. (We can also work with you on how to introduce new animals into your home):

Please describe where the pet will stay when you are at home:

Please describe where the pet will stay when you are away:

Please describe where the pet will sleep at night:

How many hours per day will the pet be alone?

Do you have a crate?

YesNo

Do you plan to use a crate

YesNo

Why or why not?

If yes, how many hours per day will the pet be crated?

What kinds of solutions would you be willing to try if housebreaking accidents occurred?

Have you ever surrendered a pet to a shelter or rescue?

YesNo

If yes, why?

Have you ever had a pet euthanized?

YesNo

If yes, why?

References

Many veterinarians will not release information to us without your permission. Please let your vet know that someone will be calling them and that it is OK to release information to us. Please indicate below that you have contacted them know that someone will be calling and you have given your permission for them to release information to SCR.

I called my veterinarian(s) on this date:

MonthDayYear

and I spoke with:

Approximate date of last vet visit:

Please provide us with your current veterinarian information (required):

Vet Name:

Phone:

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Please provide two references not related to you:*

	Name	Phone #	Email Address	Preferred Contact Method
Reference # 1
Reference # 2

My answers are true and complete to the best of my knowledge.

Signature

Date

You can type your name above but we may require your signature at some point when an Spirit Canine Rescue representative meets with you.

If you have questions, please email us at apps@spiritcaninerescue.org

Please view our complete adoption policies here.

Form last revised March 2016